Risk factors for pulmonary mucormycosis in subjects with diabetes mellitus—A case‐control study

Background Factors associated with pulmonary mucormycosis (PM) among subjects with diabetes mellitus (DM) remain unclear. Following the coronavirus disease (COVID‐19)‐associated mucormycosis outbreak in India, specific environmental exposures (especially cattle dung exposure) were proposed as possib...

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Vydané v:Mycoses Ročník 66; číslo 9; s. 787 - 794
Hlavní autori: Garg, Deepak, Soundappan, Kathirvel, Agarwal, Ritesh, Mukherjee, Soham, Kumar, Mahendra, Dhooria, Sahajal, Sehgal, Inderpaul Singh, Prasad, Kuruswamy Thurai, Ramachandran, Raja, Patil, Shivakumar, Aggarwal, Ashutosh Nath, Rudramurthy, Shivaprakash Mandya, Chakrabarti, Arunaloke, Muthu, Valliappan
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Germany Wiley Subscription Services, Inc 01.09.2023
Predmet:
aspergillosis
Cattle
Coronaviruses
COVID-19
cow dung
Demography
Diabetes
Diabetes mellitus
diabetic ketoacidosis
Dung
Environmental factors
Hemoglobin
Mucorales
Mucormycosis
Rhizopus
Risk factors
zygomycosis
zygomycosis
Mucorales
diabetic ketoacidosis
cow dung
Rhizopus
aspergillosis
ISSN:0933-7407, 1439-0507, 1439-0507
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Shrnutí:Background Factors associated with pulmonary mucormycosis (PM) among subjects with diabetes mellitus (DM) remain unclear. Following the coronavirus disease (COVID‐19)‐associated mucormycosis outbreak in India, specific environmental exposures (especially cattle dung exposure) were proposed as possible aetiology. We hypothesized that environmental factors are associated with PM. We compared subjects with DM with (cases) and without PM (controls). Methods In this case‐control study, for each PM case, we included five unmatched diabetic controls (hospital [n = 2], community [n = 3]) without PM. We collected information on demography, COVID‐19 infection, glycated haemoglobin% (HbA1c), the type of house (pucca vs. kutcha) where the participants reside, and other environmental factors. The primary exposure tested was cattle dung exposure (CDE; using cattle dung cakes as fuel or cattle handling). We performed a multivariate logistic regression to explore factors associated with PM and report the association as an adjusted odds ratio (OR) with 95% confidence intervals (CI). Results We enrolled 39 PM cases and 199 controls (hospital [n = 80], community [n = 119]). CDE (OR 0.68, 95% CI [0.14‐3.31]; p = 0.63) was not associated with increased PM in DM. We found male sex (OR 4.07, 95% CI [1.16‐14.31]), higher HbA1c (OR 1.51, 95% CI [1.18‐16.32]), COVID‐19 (OR 28.25, 95% CI [7.02‐113.6]) and residence at kutcha house (OR 4.84, 95% CI [1.33‐17.52]) associated with PM. Conclusion Cattle dung exposure was not associated with PM in subjects with DM. Instead, male sex, poor glycaemic control, COVID‐19 and the type of housing were associated with pulmonary mucormycosis.
Bibliografia:Deepak Garg and Valliappan Muthu contributed equally to the manuscript and are the joint first authors.
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ISSN:0933-7407
1439-0507
1439-0507
DOI:10.1111/myc.13604